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目的应用品管圈探索建立和完善日间手术医院-社区延伸康复模式,优化日间手术患者社区随访管理。方法 2015年3月—8月采用品管圈活动,找出日间手术患者社区随访问题真因并制定和实施对策。研究利用品管圈活动,探索医院-社区双向转诊模式实施前后6个月(2014年9月—2015年2月,2015年9月—2016年2月)日间手术患者接受健康教育、术后随访换药模式转变、医患满意度等指标的差异。结果实施品管圈活动后,日间手术患者人均在医院完成复诊随访换药次数由(4.58±0.95)次减少到(1.18±0.39)次,人均在社区完成复诊随访换药次数由(1.42±0.52)次增长到(4.32±0.88)次,患者人均在社区康复咨询的次数由(0.85±0.38)次增长到(6.39±1.20)次;差异均有统计学意义(P<0.001)。实施品管圈前后医生、护士工作满意度和患者满意度评分显著增高,差异有统计学意义(P<0.001)。结论实施品管圈活动促进日间手术医院-社区延伸康复模式转变,对提高日间手术患者术后康复满意度有显著成效。
Objective To explore the establishment and improvement of Day Surgery Hospital - community extended rehabilitation mode and optimize community follow-up management of day surgery patients. Methods From March to August 2015, QCC activities were used to identify the causes of community follow-up during daytime operation and to develop and implement countermeasures. Study Use of Quality Control Conduct to Explore Hospital-Community Bi-directional Referral Patterns 6 months before and after implementation (September 2014-February 2015, September 2015-February 2016) Day-to-day surgical patients receive health education and surgery Follow-up dressing change patterns, patient satisfaction and other indicators of differences. Results After the quality control circle was administered, the daily number of patients during the day surgery was reduced from (4.58 ± 0.95) to (1.18 ± 0.39) times in the hospital, and the number of follow-up per capita in the community was (1.42 ± 0.52) to (4.32 ± 0.88) times. The average number of patients in community-based rehabilitation counseling increased from (0.85 ± 0.38) to (6.39 ± 1.20) times respectively. The differences were statistically significant (P <0.001). Before and after the implementation of quality control circle, doctors ’and nurses’ job satisfaction and patient satisfaction score were significantly increased, with statistical significance (P <0.001). Conclusion The implementation of quality control activities to promote day-to-day operation of the hospital - Community Extension Rehabilitation model changes, to improve the satisfaction of postoperative rehabilitation of patients with daytime surgery have a significant effect.